It was filmed primarily in Tacloban, Leyte, in July and August of 2014, and Nedelman made a follow-up visit in November and December to premiere and promote the project. Despite his busy end-of-school-year schedule, Nedelman answered some questions for me about his work in a recent email exchange.

What was it like filming in the wake of a tragedy?

Phil Delrosario said it best. He’s the cinematographer and editor I met here at Stanford. Knowing when to turn on the camera was a “huge balancing act” between our drive to document the truth, and our obligation to be compassionate storytellers. We couldn’t ignore the emotional weight of Typhoon Haiyan, and we couldn’t ignore the fact that we weren’t part of the communities we were documenting. So we sought out people who not only wanted to share their stories with us, but who could also provide some insight as to how they wanted those stories to be seen… For one of the videos, Deaf advocates like Noemi Pamintuan-Jara reached out to us first, not the other way around… That was really special for us, to be able to work alongside a community that has been promoting Deaf accessibility and culture long before we ever arrived on the scene. And we had these new partners who could give meaningful feedback on our filmmaking decisions.

Filming in the wake of a tragedy doesn’t mean everything is tragic. The shadow of Haiyan is still there, but there’s also a sense of living in the moment and moving forward. All over the city, you’ll see posters and graffiti that say, “Tindog Tacloban!” (“Rise Tacloban!”) That’s something that really resonated with our team and the ethos of our project. You can’t tell the full story of Tacloban without optimism and resilience.

How does this film link storytelling and health, and what is special about that for you?

When I was first discussing the project with one of the producers, Roxanne Paredes, we asked ourselves a similar question: How would our project add to or nuance the coverage of the typhoon? Right after the storm, Haiyan was all over the news. Tacloban was in survival mode. But months later, after many of those cameras had left, there was a different set of long-term challenges and a focus on recovery. Those were the issues we wanted to explore, which tend to be less covered by the media but still have profound implications for community health and future disaster preparedness. In short, just because the cameras stopped rolling doesn’t mean there weren’t more stories to tell. That really broadened the way in which I think of health stories.

Today is my birthday – and the Supreme Court (or, at least, two-thirds of it) just gave me, most people who follow health policy, and millions of now still-insured Americans a present: King v. Burwell.

There’s a lot to say about this decision, but I want to focus on three things: the strength of the conflicting substantive arguments, the possible internal Court dynamics that resulted in the majority and dissenting opinion, and a guess at some deeper meanings of the case for the future of health care in America.

On the substance, this is a case that really could have gone either way. The idea that the Court should apply the words as written, no matter how silly, has precedent in the Court’s history; so does the idea that the Court should try to interpret laws in ways that make them work as intended. The majority — at the end, Chief Justice John Roberts’sopinion — does recognize this conflict; the dissent, from the more textualist end of the Court, rejects the idea of a tension. The majority has it right in the sense that sometimes the Court applies the words as written, sometimes it requires interpretation, and that both are legitimate responses to cases – both are within the culture of legal interpretation that the Court has included over the last two-and-a-quarter centuries.

I do think the Court could have legitimately gone the other way, though I think it would have been foolish and harmful, to the country and even to the conservatives who will now bemoan this outcome. I am glad they did not. I prefer judges who try, when the law – or more accurately its interpretative culture – will allow them to, to make things work in a sensible way. The dissent’s position would have upended a major government program and harmed millions of people for a technicality – like a ticky-tack penalty or foul call deciding the Super Bowl or the World Cup. The Court could have done that, but it would have been wrong.

Updated 4:07 PM: “Obamacare lives to fight another day,” writes David Studdert, ScD, a core faculty member at CHP/PCOR and an expert in health law, in a Stanford Law School blog post. In his piece, he offers more legal details of the ruling.

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Updated 1:51 PM: Stanford law professor Hank Greely, JD, has this to say:

Today is my birthday – and the Supreme Court (or, at least, two-thirds of it) just gave me, most people who follow health policy, and millions of now still-insured Americans a present: King v. Burwell…

I do think the Court could have legitimately gone the other way, though I think it would have been foolish and harmful to the country and even to the conservatives who will now bemoan this outcome. I am glad they did not. I prefer judges who try, when the law – or more accurately its interpretative culture – will allow them to, to make things work in a sensible way. The dissent’s position would have upended a major government program and harmed millions of people for a technicality – like a… foul call deciding the Super Bowl or the World Cup. The Court could have done that, but it would have been wrong…

What does it mean about the future of Obamacare? Well, I think it means the Supreme Court is done with it, at least with its fundamental, life or death issues.

Greely will expand on these thoughts in a longer piece on Scope later today.

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Updated 12:45: Mello goes into detail on the ruling in a just-published Stanford Law School blog post.

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Updated 11:51 AM: Stanford’s Laurence Baker, PhD, who has done extensive research on the economic performance of the U.S. health-care system, has also weighed in, saying, “This ruling, affirming the intent of the Affordable Care Act, is a relief for millions of Americans who have gained coverage under the law. It also provides important stability for insurers and the health-care system more broadly, avoiding what would have been tumultuous disruption in health-insurance markets in many states. We can now turn full attention back to the important work of improving health-insurance markets and expanding coverage, from which this court case was such a distraction.”

Today’s Supreme Court ruling preserves the Obama administration’s implementation of the ACA’s subsidy scheme to all qualified people (between 133 and 400 percent of the poverty line). The Supreme Court essentially ruled for the status quo.

Had the plaintiffs won the case, such subsidies would only have been legal in states, like California, that have established their own insurance exchange (or marketplace). The immediate effect of the ruling, then, would have been to eliminate federal subsidies for the people living in states without a state-established insurance exchange. Families with income between 133 and 400 percentof the poverty line in such states who purchased their insurance through a federally-established exchange would have had to pay the full costs of their insurance premiums. This would have made insurance unaffordable for many of these families.

The ruling would not have directly affected people who get insurance through their employers or through the government in some other way, such as through Medicare (health insurance for the elderly and disabled) or through Medicaid (health insurance for the poor).

It is difficult to imagine, had the ruling gone the other way, that it would be a stable political equilibrium for people in one state to be eligible for federal subsidies, while similar people in another state to be not eligible. There would have been a lot of pressure on Democrats and Republicans at both state and federal levels to reform Obamacare, and either reestablish the subsidies or make some other arrangement to make insurance affordable. With the Supreme Court ruling the way it did, there will be substantially less impetus or desire for the reform of Obamacare, especially on the Democratic side.

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Updated 10:45 AM: Stanford’s Michelle Mello, JD, PhD, professor of law and of health research and policy, has just provided her insight on the ruling, which she said offered strong claims by both sides:

The Court was profoundly influenced by its desire to avoid an interpretation of the law that would defeat Congress’s purpose in passing it. That purpose was to create a functional market through which individuals could buy insurance… The Court found it “implausible” that Congress intended for States that opted not to set up their own Exchanges to suffer the foreseeable, well-understood consequence of a “death spiral.”

The spiral occurs because without the tax credits, a very large proportion of the people who would otherwise be required to buy insurance get exempted from the individual mandate because the insurance cost exceeds a set amount of their income. That means too few people — and in particular, too few healthy people — buying insurance now… People know they can buy insurance later when they get sick. Their decisions to do so push premiums up for everyone, and the adverse selection makes the market unsustainable…

The trio writing in dissent could hardly have shown greater disgust with the majority’s approach. They disputed the majority’s threshold claim that the four little words were ambiguous — and everything that followed from it. The length and complexity of the majority’s justification for its holding, they claimed, is just proof that (once again) the justices are contorting the law in order to achieve a political objective — upholding the Affordable Care Act…

But on balance, I think the majority got it right in pointing to the well-understood consequences of withholding tax credits as evidence that Congress didn’t intend the reading the challengers urged. The decision is on firm legal ground, and to public-health advocates, is an enormous relief.

These words are all too familiar to Annete Bongiwe Moyo, a senior medical student at the University of Zimbabwe College of Health Sciences in Harare, Zimbabwe, and a former Stanford visiting scholar. In Zimbabwe, where the proportion of men to women in medical school is roughly 3:1, women are encouraged to take up professions as teachers, artists, caregivers – not doctors. And for a woman thinking about becoming a surgeon, well, she might as well keep dreaming.

Though the odds were stacked against her, Moyo made the decision to become a doctor at a very young age. But it wasn’t until she met Stanford surgeon Sherry Wren, MD, that she started to believe that becoming a surgeon was a realistic goal.

The outlook for women in surgery in Zimbabwe is not terribly unlike that in the U.S. when Wren began her residency at Yale University almost 30 years ago. After receiving her medical degree from Loyola University, Wren became the first woman from the university to specialize in surgery. At that time, only 12 percent of surgical residents were women, and the number of women surgeons in the workforce was far less.

But Wren has never let her womanhood hold her back. In fact, her powerhouse personality, fearlessness and passion for her work are the very traits that define her. She has worked all over the world, applying her skill and resourcefulness to provide the best possible care, often with extremely limited resources in remote locations. In many of these places, Wren is often the first woman surgeon anyone has ever seen.

Shocked too was Moyo when Wren appeared on her surgery rotation at the University of Zimbabwe two years ago. Here’s how Moyo recalls their first encounter – one that would have a lasting impact:

[Wren] was a visiting professor in a grand rounds. Medical students are not usually invited to grand rounds, but that day, we were permitted to attend. When the presentation was done, she asked a question, and when she looked my way, she could tell I knew the answer. She called on me, but one of my professors said ‘Wait, she’s a third year student, she may not know what you’re talking about.’ But Prof. Wren insisted, and I answered correctly. So she asked another question, and I got it right. And then another, and I got it right again.

The mood had shifted in the room. No one expected a junior female medical student could be capable of such an eloquent response. No one had ever given her the chance.

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week during the academic year; the entire blog series can be found in the SMS Unplugged category.

This is the final post in a three-part series on research in medical school. Parts one and two are available here.

In my last two posts, I explored the research paradigm of American medical training. The takeaway was that research requirements may create inefficiencies that have a host of consequences, including an unnecessarily long training process, a potential physician shortage, and an underutilization of talent.

In this post, I’ll lay out a vision for a training process that can produce a more effective physician workforce. The role of a physician has changed over time, and the education system must evolve to keep up. I’ll consider three topics: what students should get out of medical training, how schools and residency programs can help them do it, and how the system at large can enable schools to make changes.

What should students get out of medical training?

First and foremost, medical training should produce doctors who have a strong understanding of human health and disease and have the clinical skills to translate that understanding into patient care. The goal should be to produce good clinicians – that’s what the vast majority of doctors will focus on in their careers.

With that said, I accept the premise that medical training is not exclusively about clinical skills. Physicians are bright, capable individuals, and are uniquely positioned to improve the health status of their patients by other means. Schools should empower their students to pursue those opportunities. For the reasons I discussed in my last post, medical schools have decided that the primary way to do that is through research.

Research is one way to push extraordinarily important advances in medicine, but it isn’t the only way. Doctors can also improve their patients’ health by taking on roles in community health, policy, entrepreneurship or management, among others. These involve many of the same skills and techniques as research, but medical trainees don’t get exposed to these opportunities. We should.

How can schools fulfill this mission?

So how can the education system make this happen? At some point, whether it is in college or medical school, students should be given the flexibility to explore multiple domains of medicine and health care. They should then be able to pick the one or two that fit their interests and pursue them in more depth. Many students will choose to do research, while others will select other specialties. If students explore these opportunities and decide that they would rather focus on being an excellent clinician, that should also be doable.

This would allow physicians to become more effective leaders and decision-makers in the health care system. The traditional training process treats medicine as a universe of clinical practice and research, but the physician workforce has unfulfilled potential across a spectrum of other fields.

I’d been frustrated for a while with how little my patients know about cancer. They come in with all these confusions; they don’t understand the difference between chemotherapy and radiation (and from a doctor’s perspective, there’s a huge difference). They don’t understand our rationale for choosing one treatment or another or a combination. One patient was convinced that hot sauce caused cancer and was really upset that she had gotten cancer because she had gone out of her way to avoid hot sauce all of her life. I realized there is a lot of misinformation out there, and that was the purpose for starting this blog.

My wife and I have two little girls, and in the evenings sometimes they say, ‘Draw dinosaurs with me, Daddy!’ So I started drawing with them, and I enjoyed it so much that I would sometimes stay up at night after they had gone to bed, still working on my dinosaur. My wife saw me enjoying that a lot, and thought maybe I could combine this with educating people about cancer.

Your website is targeted to be generally informative about cancer; why did you start with breast cancer?

Breast cancer is really common in this country, unfortunately, and it’s also very well studied, so we understand a lot about it, which makes it a nice model. There’s a pretty clear algorithm for the proper way to treat a patient with such and such stage breast cancer, so it makes it easy to follow along.

How many characters or episodes are you hoping to do? So far, there’s just “Jane.”

I’m kind of experimenting. I envision that I’m going to follow Jane though her diagnosis and treatment, but my wife told me that Jane can’t die; she really likes Jane. But 40 percent of people with cancer will ultimately die of their disease, so I want to draw and write about what it’s like to be confronting one’s death, at least as I have witnessed it. What can medicine offer those people, and what can’t it? So I want to introduce a character who dies. I feel like there’s so much that’s already happened in Jane’s story, and I could go back and fill in the details. The mutation steps that turn a cell into a cancer cell, that’s actually a really complicated transformation that I could explore in greater depth.

In Malawi, children as young as five years old work in tobacco fields. Here, in the Silicon Valley, five-year-olds compete to attend top preschools. Stanford communications major Minkee Sohn highlighted that dramatic contrast with a parody video, “Fresh Recruits,” for a new Stanford anthropology class. Taught by Matthew Kohrman, PhD, the class, “Smoke and Mirrors in Global Health,” aimed to raise awareness about the global tobacco industry and was the subject of a recent Stanford News article.

Simply acknowledging that “smoking is bad for you” is no longer enough to halt tobacco’s spread. As noted in the piece, the tobacco industry remains a powerful global force and produces three times as many cigarettes as it did during the smoking heyday in America in the 1960s; it’s also the source of millions of preventable deaths. Kohrman encouraged his students to develop original communication strategies and to take on hard-hitting issues, such as the use of underage labor.

For their final projects, Kohrman’s class presented a slew of web-based videos, exposés and written critiques exploring little known facets of the global tobacco industry, including:

Chinese academia’s involvement in the tobacco industry

Philip Morris’ use of child labor in Africa

South Korea’s flawed approaches to tobacco control

Overall, Kohrman, an associate professor of anthropology, deemed his experimental class a “great success.” The course uncovered many little-known aspects of global tobacco, and taught students to “understand the sociocultural means by which something highly dangerous to health such as the cigarette is made both politically contentious and inert.”

Alex Giacomini is an English literature major at UC Berkeley and a writing and social media intern in the medical school’s Office of Communication and Public Affairs.

In light of recent widely covered events (and entertaining reactions on Twitter), Nature published an editorial yesterday titled, simply, “Sexism has no place in science.” It was published as a “reminder that equality in science is a battle still far from won,” and it outlines the problems of sexism and gender basis and some of the ways they can be tackled. I thought it was worth highlighting a few of their ideas here:

Recognize and address unconscious bias. Graduate students given grants by the US National Institutes of Health are required to undergo ethics training. Gender-bias training for scientists, for example, would be a powerful way to help turn the tide.

Encourage universities and research institutions to extend the deadlines for tenure or project completion for scientists (women and men) who take parental leave, and do not penalize these researchers by excluding them from annual salary rises. Many workplaces are happy to consider and agree to such extension requests when they are made. The policy should simply be adopted across the board.

Events organizers and others must invite female scientists to lecture, review, talk and write articles. And if the woman asked says no — for whatever reason — then ask others. This is about more than mere visibility. It can boost female participation too. Anecdotal reports suggest that women are more likely to ask questions in sessions chaired by women. After acknowledging our own bias towards male contributors, Nature, for example, is engaged in a continued effort to commission more women in our pages.

Do not use vocabulary and imagery that support one gender more than another. Words matter. It is not ‘political-correctness-gone-mad’ to avoid defaulting to the pronouns ‘him’ and ‘he’, or to ensure that photographs and illustrations feature women.

The piece ends on a hopeful note – “The lot of the female scientist in most developed countries is better than it was a few decades ago” – but reminds readers “that it is essential that all involved strive for better.” Hear, hear!

Scores of scholars have examined a fundamental truth of our time: Women live longer than men. But why?

After poring over data spanning centuries and continents, a team of Stanford researchers has discovered an overlooked aspect of that disparity. When there’s plenty to go around, the gap between men and women shrinks. But when adversity strikes, men die young.

And in cultures where women excel — racking up academic, professional and extracurricular accomplishments equalling or topping men — men live longer too, said Mark Cullen, MD, the first author of the recently published study that also appears in an abridged, reader-friendly form on Vox.

“The punchline is feminism is good for men too,” Cullen said.

The team posits that women are hard-wired to protect each other, an ingrained trait that goes beyond hormones and isn’t culturally dependent.

The researcher’s primary conclusion — that socio-economic stress hits men harder than women — is solid. Cullen and team looked at societies worldwide, finding that in poorer nations women live about 10 years longer than men, while in the United States the gap is closer to five years. When a social safety net is pulled out suddenly, such as following the fall of the Berlin Wall in Eastern Europe, the lifespan of men dropped nearly 15 years, Cullen said.

“Men were just dropping like flies. But that didn’t happen to women,” he said.

The team posits that women are hard-wired to protect each other, an ingrained trait that goes beyond hormones and isn’t culturally dependent.

“Women live differently,” Cullen said. “They seek each other, invest heavily in family and nurturing, which men do much less of. That’s the secret sauce — women have each other and this incredible support network.”

As women enter the workforce, and men invest in family relationships and social networks, the lifespan gap begins to lessen. “It’s the feminization of the way that men live that helps men,” he said.

As evidence, the team points to Alaska and highly developed Asian nations such as Japan and Korea. There, female lifespans far surpass male’s, probably because despite their economic success, their cultures embrace traditional gender roles. “These are places where men are men, and they die like men,” Cullen said.

Next, the team plans to continue their inquiry by investigating the hypothesis that equality helps men and search for policy programs that also boost men’s lifespans.

Imagine beginning chemotherapy without being aware of the side effects. You’re feeling sicker than you felt before the medication, experiencing nausea, muscle weakness and losing your hair. You wonder if this is normal, but you can’t interpret the drug safety information because you don’t know how to read. You’re tempted to stop taking the medication.

With one oncologist and an overstretched clinical team, clinicians at Queen Elizabeth recognized they often don’t have time to explain the chemotherapy treatment process to each patient. And, many of these patients struggle to read and comprehend complex instructions and medical terminology.

So they decided to create clinically relevant and culturally appropriate education materials designed for a low literacy patient population.

Veronica Manzo, a first-year medical student at Stanford and a member of Bhatt’s lab, is part of a team of Global Oncology volunteers developing the educational materials. She began volunteering with GO while she was working at the Dana-Farber Cancer Institute and is working to establish a chapter of the GO Young Professional Alliance at Stanford. The group held its inaugural meeting on campus last month.

“The existing materials were often too high-level for low literacy patients – wordy, complex and not designed for that culture or audience,” Manzo told me. “We looked at the most common chemotherapies in Malawi and created materials designed to target the specific side effects associated with the treatment.”

Together with Cambridge-based design firm, THE MEME Design, Manzo and a team consulted with medical and health-literacy experts to simplify complex medical information – incorporating simple language and culturally relevant illustrations – and package it in a way that could be easily printed and distributed by partners in low resource settings. The final 8-page booklet, “Cancer and You,” was introduced at Queen Elizabeth last summer and has become a helpful tool that educates patients and caregivers and improves treatment adherence.

Since the project began in 2013, the team has also collaborated with Partners in Health to modify and implement the materials in Rwanda and Haiti, and they hope to expand the work to Guatemala, India and additional sites in Africa and South America. To help support this expansion, Global Oncology has launched a 30-day fundraising campaign through Global Giving with the aim to raise $5,000 from 40 donors by the end of June.

“It’s exciting to see the positive impact the patient education materials have had in Malawi and Rwanda, and we’re looking forward to expanding this initiative to help close the gaps in patient cancer education worldwide,” said Bhatt, director of global oncology at the Center for Innovation in Global Health.